| NPI | 1760012090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: CT 038076) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 307146-7) |
| Enumeration Date | 2020-01-26 |
| Last Update Date | 2020-01-26 |