NPI | 1386010528 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 2267837) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 2267837) |
Enumeration Date | 2015-08-11 |
Last Update Date | 2016-10-11 |