| NPI | 1346466935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 200750154NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 090006687RN) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2011-10-11 |