| NPI | 1902682404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: CT 43220) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 340145) |
| Enumeration Date | 2023-08-31 |
| Last Update Date | 2023-08-31 |