| NPI | 1699165670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: VA 0002086739) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: WV 32586) |
| Enumeration Date | 2015-01-29 |
| Last Update Date | 2015-01-29 |