| NPI | 1790120558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AK 6979) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: TN 0000046755) |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2013-05-07 |