| NPI | 1194361550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 2261167) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA 2261167) |
| Enumeration Date | 2019-11-20 |
| Last Update Date | 2025-03-25 |