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 |