| NPI | 1639627219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OR 201708881NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 097000391RN) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 202011304NP-PP) | |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2021-07-08 |