| NPI | 1376200337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA 95019232) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95019232) |
| Enumeration Date | 2021-11-23 |
| Last Update Date | 2023-12-06 |