| NPI | 1700998242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 087000477N6) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 087000477RN) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-09 |