| NPI | 1922512623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 778375) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 329902) |
| Enumeration Date | 2017-11-17 |
| Last Update Date | 2019-10-01 |