| NPI | 1376863613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 000029202N1) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 000029202N6) |
| 364SP0200X Clinical Nurse Specialist, Pediatrics (Licence: OR 000029202N2) | |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2016-11-16 |