NPI | 1316499593 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN197468) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN197468) |
Enumeration Date | 2016-11-03 |
Last Update Date | 2023-01-18 |