| NPI | 1902376080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH LPN.107684.MEDS-IV) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH 107684) |
| Enumeration Date | 2018-11-30 |
| Last Update Date | 2021-08-06 |