| NPI | 1104217868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH PN.138061-M-IV) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH PN138061) |
| Enumeration Date | 2015-02-16 |
| Last Update Date | 2015-03-05 |