| NPI | 1962807800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MD R213619) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704289399) |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2014-11-04 |