| NPI | 1295011971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MI 4703110788) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH PN-145-701-M-IV) |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2015-09-02 |