| NPI | 1164617312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA RN267994) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN267994) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN267994) | |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2022-05-13 |