| NPI | 1053062398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MD T20211554) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704252423) |
| Enumeration Date | 2022-01-18 |
| Last Update Date | 2022-01-18 |