| NPI | 1013682590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 328115-01) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MD Lp55856) |
| Enumeration Date | 2021-08-16 |
| Last Update Date | 2022-01-03 |