| NPI | 1104542877 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95021249) |
| Additional Taxonomies | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: CA 95154412) |
| 363LF0000X Nurse Practitioner Family (Licence: CA 95021249) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CA 95021249) | |
| 363LP2300X Nurse Practitioner Primary Care (Licence: CA 95021249) | |
| Enumeration Date | 2022-10-14 |
| Last Update Date | 2023-07-21 |