| NPI | 1790858504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: WI 57715030) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: WI 57715030) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2007-07-08 |