| NPI | 1396411781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 241511-1) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: GA 100094) |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2021-08-17 |