| NPI | 1083059588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: TN 95136) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 10 307776) |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2020-07-23 |