| NPI | 1780975623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA LPN068917) |
| Additional Taxonomies | 376K00000X Nurse's Aide (Licence: GA CN0000057044) |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2011-05-04 |