NPI | 1063958700 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95014426) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024184639) |
Enumeration Date | 2017-01-18 |
Last Update Date | 2024-10-01 |