| NPI | 1164857223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH 152995) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: WV 33534) |
| Enumeration Date | 2013-09-09 |
| Last Update Date | 2013-09-09 |