NPI | 1639708191 |
---|---|
Former Name | SAMANTHA NICOLE BALONA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: CA 684587) |
Additional Taxonomies | 251S00000X |
Enumeration Date | 2020-04-06 |
Last Update Date | 2020-04-06 |