| NPI | 1689071797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AZ LP050452) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: IL 043.088366) |
| Enumeration Date | 2014-12-04 |
| Last Update Date | 2014-12-04 |