| NPI | 1811065659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH PN104570) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MI 4703078336) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2023-03-13 |