| NPI | 1053197616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95017252) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 95017252) |
| Enumeration Date | 2023-09-07 |
| Last Update Date | 2024-05-12 |