| NPI | 1376163204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MA RN2279044) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2279044) |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2020-08-10 |