| NPI | 1942764154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: TX 201019) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: TX 209609) |
| Enumeration Date | 2019-01-22 |
| Last Update Date | 2019-01-22 |