| NPI | 1447962485 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95020026)  | 
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) | 
| Enumeration Date | 2022-12-21 | 
| Last Update Date | 2023-04-11 |