| NPI | 1053642744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 252105-1) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NC 70192) |
| Enumeration Date | 2010-01-20 |
| Last Update Date | 2010-01-20 |