| NPI | 1811410525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MD LP24474) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: PA pn102336l) |
| 164W00000X Licensed Practical Nurse (Licence: NY 119064) | |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2022-07-21 |