NPI | 1164208161 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95028999) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95250063) |
Enumeration Date | 2023-09-05 |
Last Update Date | 2024-02-08 |