| NPI | 1063771582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 778994) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 307289-1) |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2020-04-02 |