| NPI | 1457067753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AZ LP051875) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 291412) |
| Enumeration Date | 2023-01-30 |
| Last Update Date | 2023-01-30 |