| NPI | 1083143762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 10018238) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201501864RN) |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2024-06-20 |