| NPI | 1912529025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA LPN071336) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NJ 26NP05001700) |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2020-05-12 |