| NPI | 1578801973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: SC 54882) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 313344-1) |
| Enumeration Date | 2013-01-21 |
| Last Update Date | 2025-02-09 |