| NPI | 1053913939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MI 4704346392) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 591386) |
| Enumeration Date | 2020-11-14 |
| Last Update Date | 2020-11-14 |