| NPI | 1962884619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NY 317201) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: CT 038159) |
| Enumeration Date | 2015-06-18 |
| Last Update Date | 2015-06-18 |