| NPI | 1043673049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 217321) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA 217321) |
| 363LF0000X Nurse Practitioner, Family (Licence: VT 101.0134767) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 6481) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VT 101.0134767) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 6481) | |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2021-02-27 |