| NPI | 1578006193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MN R232984-4) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 0166249) |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2016-11-30 |