| NPI | 1992763890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA LPN078944) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: LA 910718) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2013-03-06 |