| NPI | 1760783625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 172A00000X Driver (Licence: OH RN721582) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH PN132109-IV) |
| Enumeration Date | 2010-11-09 |
| Last Update Date | 2022-07-20 |