| NPI | 1649779307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH 128060) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: SC PR44912) |
| Enumeration Date | 2018-02-08 |
| Last Update Date | 2020-08-24 |