| NPI | 1649798117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: FL PN5204676) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: AK NURP7031) |
| Enumeration Date | 2017-09-05 |
| Last Update Date | 2017-09-11 |