| NPI | 1285279398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MA RN2282354) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2282354) |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2020-10-01 |