| NPI | 1720723851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 202211731NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 930386823) |
| Enumeration Date | 2022-05-03 |
| Last Update Date | 2022-10-24 |