| NPI | 1225484066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95004557) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95004557) |
| 163W00000X Registered Nurse (Licence: CA 840595) | |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2019-09-19 |