| NPI | 1104150812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 295328-1) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 295328) |
| Enumeration Date | 2009-09-28 |
| Last Update Date | 2021-07-29 |