| NPI | 1629807862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: VA 0001279107) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704271193) |
| Enumeration Date | 2024-07-27 |
| Last Update Date | 2024-07-27 |