| NPI | 1053703504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201802878NP-PP) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID 61328) |
| 363LF0000X Nurse Practitioner, Family (Licence: ID 61328) | |
| Enumeration Date | 2015-02-20 |
| Last Update Date | 2024-10-25 |