| NPI | 1235408550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NC 82428) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 305957) |
| Enumeration Date | 2011-12-15 |
| Last Update Date | 2024-04-12 |