| NPI | 1366637639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 272669-1) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: PA 270623) |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2007-09-10 |