| NPI | 1073949970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2288512) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MA 2288512) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2288512) | |
| Enumeration Date | 2013-09-24 |
| Last Update Date | 2015-09-18 |