| NPI | 1700191764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: FL pn5198048) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH pn.136152-m-iv) |
| Enumeration Date | 2010-08-15 |
| Last Update Date | 2011-11-22 |