| NPI | 1174241517 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MI 4703129877) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: WV 19911) |
| Enumeration Date | 2022-08-22 |
| Last Update Date | 2024-08-06 |