| NPI | 1912261355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA lpn068670) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: CT 030609) |
| 164W00000X Licensed Practical Nurse (Licence: NY 317332) | |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2013-12-20 |