| NPI | 1861734816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MI 4703119998) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: WI 309638-31) |
| Enumeration Date | 2013-03-17 |
| Last Update Date | 2018-12-04 |