| NPI | 1376069682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: MI 4703118320) |
| 164W00000X Licensed Practical Nurse (Licence: MI 4703118320) | |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2021-03-28 |