| NPI | 1992128383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201507674NP-PP) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AL 1-143128) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 2324823) | |
| Enumeration Date | 2014-01-21 |
| Last Update Date | 2019-07-11 |