| NPI | 1205308780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 10015740) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 377875-4405) |
| Enumeration Date | 2018-12-21 |
| Last Update Date | 2023-12-19 |