| NPI | 1962603183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: PA PN 267042) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: DE L2-0008757) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2007-07-08 |