| NPI | 1205231289 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: OH RN.408134) |
| Additional Taxonomies | 3747A0650X Technician, Attendant Care Provider (Licence: OH RN.408134) |
| Enumeration Date | 2014-11-03 |
| Last Update Date | 2022-03-02 |