| NPI | 1033610449 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: TX 230493)  | 
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX 230493)  | 
| Enumeration Date | 2018-02-22 | 
| Last Update Date | 2018-02-22 |