| NPI | 1689045551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: CA 95417711) |
| Additional Taxonomies | 167G00000X Licensed Psychiatric Technician (Licence: CA 66274) |
| Enumeration Date | 2015-10-16 |
| Last Update Date | 2025-09-24 |