| NPI | 1194426171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2359040) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2359040) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-03-15 |
| Last Update Date | 2023-07-31 |