| NPI | 1164217162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 10047534) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201390056RN) |
| Enumeration Date | 2025-04-10 |
| Last Update Date | 2025-07-29 |