| NPI | 1255951604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH 171711) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: GA LPN100121) |
| Enumeration Date | 2020-04-24 |
| Last Update Date | 2022-01-17 |