| NPI | 1730624941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201900092NPPP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201810546RN) |
| Enumeration Date | 2016-12-23 |
| Last Update Date | 2020-02-12 |