| NPI | 1174592240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: IN 28151799A) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IN 36000457A) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2007-07-08 |