| 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 |