| NPI | 1710369269 |
|---|---|
| Former Name | DANIELLE SELLENA MATTHEWS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH 143980) |
| Additional Taxonomies | 347C00000X Private Vehicle (Licence: OH rq568963) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2015-06-22 |