| NPI | 1912476185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH MIV148308) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: PA PN298042) |
| Enumeration Date | 2018-11-17 |
| Last Update Date | 2018-11-17 |