| NPI | 1578939013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95005806) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: CA 834727) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2024-09-24 |