| NPI | 1508647579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 341712-01) |
| Additional Taxonomies | 251E00000X Home Health (Licence: NY 341712) |
| Enumeration Date | 2023-10-06 |
| Last Update Date | 2023-10-13 |