| NPI | 1922659465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH 172273) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: WV 31840) |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2019-09-26 |