| NPI | 1124723812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: FL PN5219048) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: TX PN52190) |
| Enumeration Date | 2023-04-03 |
| Last Update Date | 2023-04-03 |