| NPI | 1568750677 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MI 4704172686) | 
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator (Licence: MI 4704172686) | 
| Enumeration Date | 2011-07-11 | 
| Last Update Date | 2011-07-11 |