| NPI | 1023066446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: OR 201250209NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OR 200550161NP) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2015-08-04 |