| NPI | 1114419777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95012355) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95057994) |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2019-08-15 |