| NPI | 1104199652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: GA RN202655) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-121056) |
| Enumeration Date | 2012-02-14 |
| Last Update Date | 2012-02-14 |