| NPI | 1780980797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: FL 196-13069) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: FL PN5154846) |
| Enumeration Date | 2011-02-09 |
| Last Update Date | 2011-02-09 |