| NPI | 1083457956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95038372) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95038372) |
| 163W00000X Registered Nurse (Licence: CA 95284470) | |
| Enumeration Date | 2024-06-17 |
| Last Update Date | 2026-07-20 |