| NPI | 1225755473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MI 4703102720) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MI 21190045036) |
| Enumeration Date | 2022-10-27 |
| Last Update Date | 2022-10-27 |