| NPI | 1639749773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA AG12200040) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: CA AG12200040) |
| Enumeration Date | 2021-06-30 |
| Last Update Date | 2021-08-18 |