| NPI | 1770989410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CA 95002385) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CA 781827) |
| 363LF0000X Nurse Practitioner Family (Licence: CA 95002385) | |
| Enumeration Date | 2014-11-07 |
| Last Update Date | 2020-01-07 |