| NPI | 1083959696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: WI 118424 - 030) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.281469) |
| Enumeration Date | 2012-12-07 |
| Last Update Date | 2013-10-03 |