| NPI | 1639692718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH LPN.163659.MEDS-IV) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: LPN.163659.MEDS-IV) |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2017-07-20 |