| NPI | 1912349804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA LPN061302) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: GA 061302) |
| Enumeration Date | 2013-07-22 |
| Last Update Date | 2020-03-23 |