| NPI | 1891112652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: CA 51482) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA51482) |
| Enumeration Date | 2014-03-18 |
| Last Update Date | 2022-01-03 |