| NPI | 1710669817 |
|---|---|
| Former Name | MARTHA M DE LA VEGA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: CA 95125466) |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2023-08-07 |