| NPI | 1710133764 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 202007260NP) | 
| Additional Taxonomies | 367A00000X Advanced Practice Midwife (Licence: OR 200850104NP) | 
| Enumeration Date | 2008-08-11 | 
| Last Update Date | 2020-08-26 |