| NPI | 1457499956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: OR 0000366690N3) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: OR 0000366690N6) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2009-03-03 |