| NPI | 1780178566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 246305-1) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: PA PN268756) |
| Enumeration Date | 2018-06-15 |
| Last Update Date | 2018-06-15 |