| NPI | 1073209144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 10006490) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 099000617RN) |
| 163WL0100X Registered Nurse, Lactation Consultant (Licence: OR L-14236) | |
| Enumeration Date | 2023-04-12 |
| Last Update Date | 2024-10-29 |