| NPI | 1508193616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MO 2008008485) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.372952) |
| Enumeration Date | 2009-11-10 |
| Last Update Date | 2009-11-10 |