| 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 |