| NPI | 1619503695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5013022) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 202113644RN) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 202203358NP-PP) | |
| Enumeration Date | 2020-03-21 |
| Last Update Date | 2023-03-14 |