| NPI | 1982311288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 167G00000X Licensed Psychiatric Technician (Licence: CA 705767) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA 705767) |
| Enumeration Date | 2022-11-04 |
| Last Update Date | 2022-11-04 |