| NPI | 1164078713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MA 2284228) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 2284228) |
| Enumeration Date | 2019-08-09 |
| Last Update Date | 2020-06-02 |