| NPI | 1073060711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95004701) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95004701) |
| Enumeration Date | 2016-09-09 |
| Last Update Date | 2021-09-28 |