| NPI | 1184975765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MA RN2364653) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: ME CNP121098) |
| 363LF0000X Nurse Practitioner Family (Licence: ME CNP121098) | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MD LCM875) | |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2022-06-09 |