| NPI | 1790198844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: FL pn5206631) |
| Additional Taxonomies | 3747P1801X Technician, Personal Care Attendant (Licence: FL pn5206631) |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2014-06-06 |