| NPI | 1760576912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: FL PN670651) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: AZ PN670651) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-07-08 |