| NPI | 1669759387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MD LP28231) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: PA PN265791) |
| Enumeration Date | 2011-11-09 |
| Last Update Date | 2011-11-09 |