| NPI | 1790789063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 163WG0000X Registered Nurse General Practice |
| Additional Taxonomies | 163WG0000X Registered Nurse General Practice (Licence: MI 4704135541) |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2007-07-08 |