| NPI | 1720443971 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: AZ RN069410)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AK 104217)  | 
| Enumeration Date | 2015-12-15 | 
| Last Update Date | 2015-12-15 |