| NPI | 1639587140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 308321) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NJ 26np06650100) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2014-07-28 |