| NPI | 1124678792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: CA 730470) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-09-16 |
| Last Update Date | 2026-05-22 |