| NPI | 1679919112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: TN 99707) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 304429) |
| Enumeration Date | 2013-05-10 |
| Last Update Date | 2023-05-12 |