| NPI | 1629624739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH 168707) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OK 168707) |
| Enumeration Date | 2019-08-14 |
| Last Update Date | 2019-08-14 |