| NPI | 1689979510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: NC 101-117460) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NC 049048) |
| Enumeration Date | 2011-01-25 |
| Last Update Date | 2011-01-25 |