| NPI | 1336496504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 310599) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: IL 043114855) |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2012-08-07 |