Individual
GRMAWIT WOLDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
512 W 134 #23, BRONX, NM 10466
(646) 407-6369
Mailing address
512 W 134 #23, BRONX, NY 10466
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
301729
NM
Other
Enumeration date
12/07/2018
Last updated
12/07/2018
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