| NPI | 1316779077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA A MORENO Volunteer 661-308-8250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2024-08-20 |
| Last Update Date | 2024-10-28 |