| NPI | 1235690413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: AL 1-137437) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704350419) |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2019-03-29 |