| NPI | 1902526619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MI 4703123751) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: MI 4703123751) |
| Enumeration Date | 2022-09-01 |
| Last Update Date | 2022-09-01 |