| NPI | 1316964158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 200450068NP) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 90007316N3) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2019-04-09 |