| NPI | 1073533451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 10021159) |
| Additional Taxonomies | 174400000X Specialist (Licence: OR 7866) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2024-09-07 |