| NPI | 1689317299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: TX 1007710) |
| Additional Taxonomies | 167G00000X Licensed Psychiatric Technician (Licence: TX 1007710) |
| Enumeration Date | 2022-04-20 |
| Last Update Date | 2022-04-20 |