| NPI | 1467204156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MI 4703123796) |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2024-04-04 |
| Last Update Date | 2024-04-04 |