| NPI | 1124562160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 252092) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NY 032009-01) |
| Enumeration Date | 2016-12-09 |
| Last Update Date | 2020-11-20 |