| NPI | 1073148540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MA RN2318611) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MA RN2318611) |
| 207R00000X Internal Medicine (Licence: MA RN2318611) | |
| Enumeration Date | 2020-03-05 |
| Last Update Date | 2024-06-10 |