| NPI | 1942617493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95000318) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95000318) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95000318) | |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2021-11-16 |