| NPI | 1255327151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 200850154np) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 096007344n1) |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2012-04-19 |