NPI | 1740530989 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OR 089005220LPN) |
Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: OR 089005220LPN) |
Enumeration Date | 2012-09-14 |
Last Update Date | 2012-09-14 |