| NPI | 1316501786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95010378) |
| Additional Taxonomies | 261QC1800X (Licence: CA 95010378) |
| 261QX0100X Clinic/Center, Occupational Medicine (Licence: CA 95010378) | |
| 261QP2300X Clinic/Center, Primary Care (Licence: CA 95010378) | |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2023-05-25 |