| NPI | 1669857918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA LPN053612) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: SC LPN.46673PR) |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2015-07-29 |