NPI | 1164001038 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95026103) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95141770) |
Enumeration Date | 2021-04-06 |
Last Update Date | 2023-08-10 |