| NPI | 1568912731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH LPN.155821.MEDS-IV) |
| Additional Taxonomies | 126800000X Dental Assistant |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2017-10-12 |