| NPI | 1811480288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MI 4703085995) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: WY 8352) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2018-06-11 |