| NPI | 1669922613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MI 4703120295) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2024-04-29 |