| NPI | 1770851750 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201400922NP-PP) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 178665) | 
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AK NURU1271) | |
| Enumeration Date | 2011-12-06 | 
| Last Update Date | 2016-12-27 |