| NPI | 1376840991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AL 2-071733) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 303243) |
| Enumeration Date | 2011-02-16 |
| Last Update Date | 2021-03-05 |