| NPI | 1710673660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95025078) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA 95104506) |
| Enumeration Date | 2023-04-13 |
| Last Update Date | 2023-07-24 |