| NPI | 1912398959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: HI 18054) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: TN 83743) |
| Enumeration Date | 2015-02-12 |
| Last Update Date | 2015-02-16 |