| NPI | 1689180507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA LPN091032) |
| Additional Taxonomies | 183700000X Pharmacy Technician (Licence: GA PHTC007718) |
| Enumeration Date | 2017-12-15 |
| Last Update Date | 2017-12-15 |