| NPI | 1962052746 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: AZ 204633)  | 
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: AZ 204633)  | 
| 163WW0101X Registered Nurse, Women's Health Care, Ambulatory (Licence: AZ 204633)  | |
| Enumeration Date | 2019-09-13 | 
| Last Update Date | 2019-09-13 |