| NPI | 1992415871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: OH 145869) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OR 201709187LPN) |
| 164W00000X Licensed Practical Nurse (Licence: ID 15957) | |
| Enumeration Date | 2022-12-01 |
| Last Update Date | 2022-12-01 |