| NPI | 1558826875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 310443-1) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: NY 310443) |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2019-01-31 |