NPI | 1053752485 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CA 21719) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CA 21719) |
Enumeration Date | 2013-07-15 |
Last Update Date | 2019-10-23 |