| NPI | 1750717617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201801794NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 201243065RN) |
| Enumeration Date | 2013-09-23 |
| Last Update Date | 2019-02-08 |