| NPI | 1790958908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH PN 121606 IV) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH 121606) |
| Enumeration Date | 2008-04-09 |
| Last Update Date | 2020-07-22 |