| NPI | 1669856035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OK 29631) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: AR L030492) |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2018-03-17 |