| NPI | 1326754573 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2359144) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NH 087798-21) |
| 163W00000X Registered Nurse (Licence: MA RN2359144) | |
| Enumeration Date | 2023-01-30 |
| Last Update Date | 2023-10-17 |