| NPI | 1063824795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 761629) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 317056) |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2018-12-18 |