| NPI | 1760780068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA LPN078474) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MD LP43714) |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2011-03-11 |