| NPI | 1053690420 |
|---|---|
| Former Name | MICKY WILLIAMS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 305513-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 757926) |
| Enumeration Date | 2011-08-16 |
| Last Update Date | 2019-11-01 |