| NPI | 1710082490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 550) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA MFT 27928) |
| 163W00000X Registered Nurse (Licence: CA 309342) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2009-05-21 |