| NPI | 1972286995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: NC 91202) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OH LPN.091158.MEDS-IV) |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2023-08-08 |