| NPI | 1639336084 |
|---|---|
| Former Name | DIANE MARIE DE LOS REYES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 686985) |
| 163W00000X Registered Nurse (Licence: CA 71745) | |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2009-01-27 |