| NPI | 1003108572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 278790) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: CT 11.035623) |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2011-05-03 |