| NPI | 1407625643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95029221) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95080528) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 2023086040) | |
| Enumeration Date | 2023-12-29 |
| Last Update Date | 2024-10-04 |