| NPI | 1114560182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95021862) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 712240) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 404183) | |
| Enumeration Date | 2019-10-23 |
| Last Update Date | 2023-05-17 |