| NPI | 1134457112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95005317) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95005317) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704247772) | |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2023-08-25 |