| NPI | 1407135114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 306519) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NJ 26NP06640000) |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2011-08-11 |