| NPI | 1528447794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH 158948) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: WV 28695) |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2015-05-21 |