| NPI | 1477708147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MO 107646) |
| Additional Taxonomies | 163WC1400X Registered Nurse, College Health (Licence: MO 107646) |
| Enumeration Date | 2008-11-23 |
| Last Update Date | 2011-10-10 |