| NPI | 1174929285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: WI 221487) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: WI 318084) |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2015-03-12 |