| NPI | 1114273182 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95000070)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 802018)  | 
| Enumeration Date | 2012-07-27 | 
| Last Update Date | 2014-12-09 |