| NPI | 1245484641 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN277449)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 277449)  | 
| 363L00000X Nurse Practitioner (Licence: MA RN277449)  | |
| Enumeration Date | 2008-11-12 | 
| Last Update Date | 2020-12-23 |