| NPI | 1700435443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA LPN73434) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: TN 73434) |
| Enumeration Date | 2019-09-05 |
| Last Update Date | 2024-06-26 |