| NPI | 1295003770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 284084) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 284084) |
| Enumeration Date | 2011-12-12 |
| Last Update Date | 2011-12-12 |