| NPI | 1679293666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NM 68277) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH LPN.165653.MEDS-IV) |
| Enumeration Date | 2022-08-30 |
| Last Update Date | 2022-08-30 |