| NPI | 1760112619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 329359) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 329359) |
| Enumeration Date | 2022-06-14 |
| Last Update Date | 2022-06-14 |