| NPI | 1679466478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: TX 669044) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2025-05-30 |
| Last Update Date | 2025-05-30 |