| NPI | 1154676120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 309789) |
| Additional Taxonomies | 3140N1450X Skilled Nursing Facility, Nursing Care, Pediatric (Licence: NY 309789) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2012-07-17 |