| NPI | 1760298525 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TN 274370) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN10008919) |
| Enumeration Date | 2024-12-06 |
| Last Update Date | 2024-12-06 |