| NPI | 1700031036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TN RN0000107051) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2008-12-01 |
| Last Update Date | 2009-02-25 |