NPI | 1548677453 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95006293) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95108751) |
163W00000X Registered Nurse (Licence: NY 679782) | |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 401912) | |
Enumeration Date | 2014-07-14 |
Last Update Date | 2017-06-06 |