| NPI | 1174652002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 9664) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA B333567-9664) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2021-07-02 |