| NPI | 1104461938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95022173) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 748392) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95022173) | |
| Enumeration Date | 2019-11-15 |
| Last Update Date | 2024-08-16 |