| NPI | 1003688904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: CA VN746412) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2023-10-24 |
| Last Update Date | 2024-11-04 |