| NPI | 1396453098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172A00000X Driver (Licence: OH TJ066337) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH LPN.166085.MEDS-IV) |
| Enumeration Date | 2022-11-10 |
| Last Update Date | 2022-11-10 |