| NPI | 1629712393 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH 150609) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH 145318.MEDS.IV) |
| Enumeration Date | 2022-04-27 |
| Last Update Date | 2022-04-27 |