| NPI | 1740531599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: WY 7632) |
| Additional Taxonomies | 261QP0904X Clinic/Center Public Health, Federal (Licence: WY 7632) |
| Enumeration Date | 2012-09-19 |
| Last Update Date | 2012-09-19 |