| NPI | 1104167758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 23310) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 507599) |
| 174H00000X Health Educator (Licence: CA 507599) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 23310) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 23310) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: CA 23310) | |
| Enumeration Date | 2013-03-06 |
| Last Update Date | 2025-07-31 |