| NPI | 1104211259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH PN.154156-M-IV) |
| Additional Taxonomies | 376K00000X Nurse's Aide |
| Enumeration Date | 2015-04-04 |
| Last Update Date | 2015-04-04 |