| NPI | 1215400585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH LPN.162827.MEDS-IV) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH 162827) |
| Enumeration Date | 2019-01-09 |
| Last Update Date | 2020-10-16 |