| NPI | 1730585050 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AZ LP048968)  | 
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: GA LPN076877)  | 
| Enumeration Date | 2014-11-13 | 
| Last Update Date | 2017-03-08 |