| NPI | 1619636727 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MI 4703126759) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH LPN.178481.MEDS-IV) |
| Enumeration Date | 2021-12-16 |
| Last Update Date | 2025-01-03 |