| NPI | 1770356065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95029840) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95171743) |
| 363L00000X Nurse Practitioner (Licence: CA 95029840) | |
| Enumeration Date | 2023-10-30 |
| Last Update Date | 2024-10-03 |