| NPI | 1063499168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA MW0400755I) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 232427) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2025-06-27 |