NPI | 1124545645 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/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 |