| NPI | 1780843516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 292601-1) |
| Additional Taxonomies | 163WG0000X Registered Nurse General Practice (Licence: LA 211984) |
| 363LF0000X Nurse Practitioner Family (Licence: LA 211984) | |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2020-04-08 |