| NPI | 1770710121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: FL PN5230612) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 278693-1) |
| Enumeration Date | 2009-06-12 |
| Last Update Date | 2018-10-01 |