| NPI | 1003361551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2282404) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95074763) |
| 163W00000X Registered Nurse (Licence: NY 662607) | |
| 163W00000X Registered Nurse (Licence: MA 2282404) | |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2018-05-29 |