| NPI | 1750507778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MT 15113) |
| Additional Taxonomies | 163WC1400X Registered Nurse, College Health (Licence: MT 15113) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2007-07-08 |