| NPI | 1104165299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95025745) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 685360) |
| Enumeration Date | 2013-02-08 |
| Last Update Date | 2024-10-09 |