| NPI | 1013481290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA F11180808) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MA RN22914439) |
| Enumeration Date | 2019-01-21 |
| Last Update Date | 2019-01-21 |