| NPI | 1902170988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MS P325240) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: LA 20100495) |
| Enumeration Date | 2012-03-08 |
| Last Update Date | 2012-03-08 |