NPI | 1104422930 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95031515) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95197861) |
Enumeration Date | 2020-12-08 |
Last Update Date | 2024-10-28 |