| NPI | 1659879435 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 95336508) |
| Additional Taxonomies | 167G00000X Licensed Psychiatric Technician (Licence: CA 40603) |
| Enumeration Date | 2018-01-26 |
| Last Update Date | 2023-07-24 |