| NPI | 1053132902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95032818) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95237721) |
| Enumeration Date | 2024-10-23 |
| Last Update Date | 2026-07-27 |