| NPI | 1053704312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: TX 344386) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 284636-1) |
| Enumeration Date | 2015-03-11 |
| Last Update Date | 2019-08-30 |