NPI | 1679871776 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MA 39035) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: RI 08525) |
Enumeration Date | 2011-03-14 |
Last Update Date | 2011-03-14 |