| NPI | 1972066561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: PA PN319370) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 211588) |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2023-07-06 |