| NPI | 1659772275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA LPN053047) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: GA LPN053047) |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2014-09-15 |