| NPI | 1215393897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 314973) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MO 2013041593) |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2016-01-12 |