| NPI | 1124447602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: WY 21553) |
| Additional Taxonomies | 163WG0000X Registered Nurse General Practice (Licence: WY 21553) |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2014-04-10 |