| NPI | 1083260475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: CA LVN728968) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-08-13 |
| Last Update Date | 2025-08-15 |