NPI | 1124782115 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95025305) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95186824) |
Enumeration Date | 2021-10-26 |
Last Update Date | 2023-09-20 |