| NPI | 1790946135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95025040) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA VN157231) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2024-11-22 |