| NPI | 1376261032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95023427) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95311802) |
| 163W00000X Registered Nurse (Licence: MN 2464205) | |
| Enumeration Date | 2022-08-18 |
| Last Update Date | 2022-11-28 |