| NPI | 1053568055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN274041) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 274041) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN274041) | |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2021-09-08 |