| NPI | 1790031946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 19262) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 538891) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 19262) | |
| Enumeration Date | 2012-07-25 |
| Last Update Date | 2012-07-25 |