| NPI | 1942645015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: IL 043110294) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MO 2012031074) |
| Enumeration Date | 2013-05-02 |
| Last Update Date | 2013-05-02 |