| NPI | 1073163408 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 202108941NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 200141627RN) |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2023-05-22 |