| NPI | 1861112203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95028676) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 577105) |
| 364S00000X Clinical Nurse Specialist (Licence: CA 2200) | |
| Enumeration Date | 2022-08-29 |
| Last Update Date | 2024-01-23 |