| NPI | 1518239292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH 141375) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MI 4703105659) |
| Enumeration Date | 2012-01-27 |
| Last Update Date | 2019-12-18 |