| NPI | 1356048482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MI 4703120870) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MI 4703122556) |
| Enumeration Date | 2023-02-09 |
| Last Update Date | 2023-02-15 |