| NPI | 1720779184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 95025212) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 851853) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CA 95025212) | |
| Enumeration Date | 2023-05-17 |
| Last Update Date | 2025-03-14 |