| NPI | 1104222058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 856427-01) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 320333-1) |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2022-10-19 |