| NPI | 1568780815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 235931) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: PA PN152360L) |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2010-05-12 |