| NPI | 1134945355 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MO 2016019350) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041535375) |
| Enumeration Date | 2024-12-03 |
| Last Update Date | 2024-12-03 |