NPI | 1710521646 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95016309) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95023613) |
Enumeration Date | 2019-11-04 |
Last Update Date | 2024-08-07 |