| NPI | 1124376256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MA 215295) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 215295) |
| Enumeration Date | 2012-08-21 |
| Last Update Date | 2018-03-17 |