| NPI | 1043331408 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MA 61494)  | 
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 240605)  | 
| Enumeration Date | 2007-04-03 | 
| Last Update Date | 2007-07-08 |