| NPI | 1861099780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 376J00000X Homemaker (Licence: OH 7610393) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH LPN.127636.MEDS-IV) |
| Enumeration Date | 2020-10-04 |
| Last Update Date | 2020-10-04 |