| NPI | 1316731649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 10043665) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: OR 200641802RN) |
| Enumeration Date | 2025-04-09 |
| Last Update Date | 2025-08-13 |