| NPI | 1811715808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 10036280) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: OR 201391736RN) |
| Enumeration Date | 2024-09-30 |
| Last Update Date | 2025-01-02 |