| NPI | 1255796793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MN R179857-3) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN170179) |
| Enumeration Date | 2015-12-29 |
| Last Update Date | 2015-12-29 |