| NPI | 1083142392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: KY 1116651) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IN 28235660A) |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2018-03-17 |