| NPI | 1962631986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MO 2005009602) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: KS 24-35599-081) |
| Enumeration Date | 2009-07-12 |
| Last Update Date | 2009-07-12 |