| NPI | 1053610980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 21915) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 21915) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 21915) | |
| Enumeration Date | 2011-03-17 |
| Last Update Date | 2025-01-07 |