| NPI | 1982275301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA LPN069626) |
| Additional Taxonomies | 374700000X Technician |
| Enumeration Date | 2021-07-07 |
| Last Update Date | 2021-07-07 |