| NPI | 1639302508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201400012NP) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OR 200950125NP) |
| Enumeration Date | 2009-08-26 |
| Last Update Date | 2014-01-06 |