| NPI | 1083078265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201810266NP-PP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 2016012318) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 234275-3) | |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2019-04-08 |