| NPI | 1356054118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: OR 10002737) |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine (Licence: OR 10002737) |
| Enumeration Date | 2022-12-26 |
| Last Update Date | 2024-01-17 |