| NPI | 1487193470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 223424) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NJ 10 223424) |
| Enumeration Date | 2017-02-23 |
| Last Update Date | 2021-12-01 |