| NPI | 1720593866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: UT 1111111111) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2017-12-12 |
| Last Update Date | 2021-02-01 |