| NPI | 1972797306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NE 16114) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NE 697) |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2007-08-29 |