| NPI | 1669989463 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TX 928215) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041438833) | 
| Enumeration Date | 2018-01-03 | 
| Last Update Date | 2018-01-03 |