| NPI | 1053037424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: MA RN2261672) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2261672) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2261672) | |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2022-10-17 |