| NPI | 1174972392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95003762) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 95003762) |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2016-06-08 |