| NPI | 1083979652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN110010) |
| Additional Taxonomies | 251J00000X Nursing Care (Licence: MA 110010) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN110010) | |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2019-05-17 |