| NPI | 1093251019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA PA7752) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MA 3678) |
| Enumeration Date | 2017-01-14 |
| Last Update Date | 2021-08-22 |