| NPI | 1619279841 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH PN107220)  | 
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH PN.107220)  | 
| Enumeration Date | 2010-11-19 | 
| Last Update Date | 2010-11-19 |