NPI | 1245793124 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2312065) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MA RN2312065) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2312065) | |
Enumeration Date | 2019-04-09 |
Last Update Date | 2024-06-04 |