| NPI | 1083275374 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: TX 27648) | 
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA 682984) | 
| Enumeration Date | 2019-06-26 | 
| Last Update Date | 2019-07-06 |