| NPI | 1417013681 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA RN295812/4487) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR 171378) | 
| 363A00000X Physician Assistant (Licence: CA 51802) | |
| 363L00000X Nurse Practitioner (Licence: WA AP30003387) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CA RN295812 NP4487) | |
| Enumeration Date | 2006-12-29 | 
| Last Update Date | 2021-02-25 |