| NPI | 1003641804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN10007757) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 274411) |
| 163W00000X Registered Nurse (Licence: MA RN10007757) | |
| Enumeration Date | 2024-09-03 |
| Last Update Date | 2024-10-30 |