| NPI | 1629852876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171W00000X Contractor |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH LPN.181353.MEDS-IV) |
| 211D00000X Assistant, Podiatric | |
| 172A00000X Driver | |
| Enumeration Date | 2023-08-21 |
| Last Update Date | 2023-08-21 |