| NPI | 1407361116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MI 4703084932) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MI 47030384932) |
| Enumeration Date | 2017-12-05 |
| Last Update Date | 2017-12-05 |