| NPI | 1508999467 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MI 4703109919) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH PN113942) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2013-08-28 |