| NPI | 1639768773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: TX 348842) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: FL PN5245760) |
| Enumeration Date | 2021-01-13 |
| Last Update Date | 2021-01-13 |