| NPI | 1205287216 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95010659) | 
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA 624603) | 
| 363L00000X Nurse Practitioner (Licence: CA 95010659) | |
| Enumeration Date | 2016-06-30 | 
| Last Update Date | 2021-01-23 |