| NPI | 1902261613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95030353) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 820364) |
| Enumeration Date | 2015-12-22 |
| Last Update Date | 2024-07-04 |