| NPI | 1114203767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2257719) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA N2257719) |
| 163W00000X Registered Nurse (Licence: MA RN2257719) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2257719) | |
| Enumeration Date | 2011-10-27 |
| Last Update Date | 2024-01-02 |