| NPI | 1962534263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY F304157) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY F304157) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2016-06-06 |