| NPI | 1982975561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: CT 035925) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 310014) |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2012-05-17 |