| NPI | 1306191259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MD R210497) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MI LP48759) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2018-05-01 |