| NPI | 1407929581 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 14122) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: CA 568972) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2014-08-25 |