| NPI | 1316572779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH LPN.101260.MEDS) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: CO PN0335989) |
| Enumeration Date | 2020-03-05 |
| Last Update Date | 2020-11-12 |