| NPI | 1104638378 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: CA PA65730) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA65730) |
| Enumeration Date | 2025-01-23 |
| Last Update Date | 2025-08-28 |