| NPI | 1306470984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: KY 2047531) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH LPN.152277.MEDS-IV) |
| Enumeration Date | 2020-02-24 |
| Last Update Date | 2022-06-15 |