| NPI | 1023488814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95005097) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95047227) |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2022-07-21 |