| NPI | 1255728440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MI 4703049522) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility (Licence: MI 4703049522) |
| Enumeration Date | 2015-04-25 |
| Last Update Date | 2015-04-29 |