| NPI | 1922852524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: NY 317530) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 317530) |
| Enumeration Date | 2024-04-11 |
| Last Update Date | 2024-04-11 |