| NPI | 1962063818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: WA 60939888) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH 170565) |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2019-06-21 |