NPI | 1104225341 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN284646) |
Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MA 284646) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN284646) | |
Enumeration Date | 2014-08-13 |
Last Update Date | 2023-05-03 |