| NPI | 1730170085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 200550159NPPMHNP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 000033401RN) |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2011-08-01 |