| NPI | 1194590281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95028486) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95231737) |
| Enumeration Date | 2023-11-17 |
| Last Update Date | 2026-06-22 |