| NPI | 1659768448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AZ tlp050903) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: IL 043.101666) |
| Enumeration Date | 2015-04-20 |
| Last Update Date | 2015-04-20 |