| NPI | 1124545645 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95011030)  | 
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: CA 95075817)  | 
| Enumeration Date | 2017-08-25 | 
| Last Update Date | 2019-06-19 |