| NPI | 1275994600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 2022063774) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA F0914280) |
| Enumeration Date | 2016-03-12 |
| Last Update Date | 2023-03-02 |