| NPI | 1073779096 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 200950105NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 200743401RN) |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2014-12-01 |