| NPI | 1861744237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OR 201130654) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: TX 303851) |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2012-10-10 |