| NPI | 1659684132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 301273-1) |
| Additional Taxonomies | 167G00000X Licensed Psychiatric Technician (Licence: NY 301273) |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2010-07-29 |