| NPI | 1043559529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 2018017288) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 163W00000X Registered Nurse (Licence: OR 201141801RN) | |
| Enumeration Date | 2013-02-04 |
| Last Update Date | 2020-07-02 |