| NPI | 1861696049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 278073-1) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: PA pn275456) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2007-07-08 |