| NPI | 1730555244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MO 2013021455) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: IA P56459) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2015-08-19 |