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 |