| NPI | 1639526064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: AZ LP042342) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH LP122123) |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2016-05-16 |