| NPI | 1952844466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: CA 723434) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: OR 201393466lpn) |
| Enumeration Date | 2016-12-01 |
| Last Update Date | 2022-09-02 |