| NPI | 1639920788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MI 4703120614) |
| Additional Taxonomies | 1710I1003X Military Health Care Provider Independent Duty Medical Technicians |
| 171400000X | |
| 374U00000X Home Health Aide | |
| Enumeration Date | 2024-03-28 |
| Last Update Date | 2024-03-28 |