| NPI | 1861924011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH 165405) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: IL 043.084289) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2017-07-21 |