| NPI | 1619039005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY16435) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 302448 - 3652) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2007-07-08 |