| NPI | 1760994271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MD 52319) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: WV 32897) |
| Enumeration Date | 2017-10-25 |
| Last Update Date | 2017-10-25 |