| NPI | 1093215865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: TX 333497) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MA LN93498) |
| Enumeration Date | 2018-02-17 |
| Last Update Date | 2018-02-17 |