| NPI | 1003164310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 2013010380) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2281183) |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2022-09-06 |