NPI | 1407239262 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95002524) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95002524) |
363LP2300X Nurse Practitioner, Primary Care (Licence: CA 95002524) | |
Enumeration Date | 2015-06-29 |
Last Update Date | 2022-05-18 |