NPI | 1053133595 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95032849) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 1053145) |
Enumeration Date | 2024-10-28 |
Last Update Date | 2024-11-07 |