| NPI | 1952648495 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WS0200X Registered Nurse, School (Licence: NY 611992-1) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NY 611992-1) |
| Enumeration Date | 2013-01-03 |
| Last Update Date | 2013-01-03 |