| NPI | 1770884538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: PA PN283106) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: DE L2-0010367) |
| Enumeration Date | 2010-11-10 |
| Last Update Date | 2010-11-10 |