| NPI | 1073602207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201707022) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MT 19903) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2025-10-06 |