| NPI | 1154872695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201705893NP-PP) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OR 200841282RN) |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2023-07-27 |