| NPI | 1942607338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AZ LP049532) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: AK 148861) |
| Enumeration Date | 2014-12-01 |
| Last Update Date | 2020-02-03 |