| NPI | 1164829396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MO 2011018492) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14-129504-071) |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2014-12-03 |