NPI | 1346627064 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2276406) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2276406) |
363LF0000X Nurse Practitioner, Family (Licence: MA RN2276406) | |
Enumeration Date | 2015-05-01 |
Last Update Date | 2025-05-08 |