NPI | 1649638974 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: OR 201508266NP-PP) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 201508266NP-PP) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201508266NP-PP) | |
Enumeration Date | 2016-02-01 |
Last Update Date | 2021-02-12 |