| NPI | 1649730151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH LPN.131543.MEDS) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: PA PN093337L) |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2019-03-21 |