| NPI | 1619264116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: PA pn300516) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 303277) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2018-09-06 |