| NPI | 1831596170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: CT 029399) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MA LN91323) |
| Enumeration Date | 2014-12-02 |
| Last Update Date | 2014-12-02 |