| NPI | 1881786697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: WI 304205031) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: IL 043088475) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2007-07-08 |