| NPI | 1780166199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: TX 212980) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: TX 212980) |
| Enumeration Date | 2018-08-31 |
| Last Update Date | 2018-08-31 |