| NPI | 1194017624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95027546) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 608) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ AP3999) | |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2025-03-23 |