| NPI | 1912143397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 200950098NP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 095000161RN) |
| Enumeration Date | 2009-01-06 |
| Last Update Date | 2014-03-03 |