| NPI | 1417464744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH LPN.167007.MEDS) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: PA PN296323) |
| Enumeration Date | 2018-01-09 |
| Last Update Date | 2018-01-09 |