| NPI | 1407397672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95015690) |
| Additional Taxonomies | 283Q00000X Psychiatric Hospital (Licence: CA 250000476) |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2022-01-19 |