| NPI | 1649625112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: PA 618192) |
| Additional Taxonomies | 247100000X Radiologic Technologist (Licence: PA 408831) |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2016-05-03 |