| NPI | 1104970508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 200650168NP) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 088000343N3) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2015-12-24 |