NPI | 1629477344 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95000984) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95000984) |
Enumeration Date | 2014-08-19 |
Last Update Date | 2021-04-21 |