| NPI | 1417095241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 200450025NP PMHNP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 200241621RN) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2017-04-27 |