| NPI | 1871180554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 258202) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: NY CRPA-3518) |
| Enumeration Date | 2020-12-29 |
| Last Update Date | 2025-09-17 |