| NPI | 1114457728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: TX 330036) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: VT 025.0117719) |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2022-07-21 |