| NPI | 1790104537 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MI 4704298128) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041-273116) | 
| 163W00000X Registered Nurse (Licence: IN 28152908A) | |
| Enumeration Date | 2014-04-09 | 
| Last Update Date | 2014-04-09 |