| NPI | 1700685757 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TX 956957) |
| Additional Taxonomies | 163WS0200X Registered Nurse, School (Licence: TX 956957) |
| Enumeration Date | 2025-03-12 |
| Last Update Date | 2025-03-12 |