| NPI | 1609343102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95010347) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 56197) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95010347) | |
| Enumeration Date | 2018-11-01 |
| Last Update Date | 2024-04-09 |