NPI | 1518388859 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: CA VN220201) |
Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
Enumeration Date | 2014-01-03 |
Last Update Date | 2014-01-03 |