| NPI | 1508457367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95028418) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1015581) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 1015581) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 95028418) | |
| Enumeration Date | 2021-02-03 |
| Last Update Date | 2025-08-25 |