| NPI | 1689894719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MN L0598693) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: SD P009904) |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2007-07-08 |