| NPI | 1174973309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MI 4703128713) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2016-06-19 |
| Last Update Date | 2024-03-16 |