| NPI | 1396150330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2301404) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2301404) |
| 164W00000X Licensed Practical Nurse (Licence: MA LN89307) | |
| Enumeration Date | 2014-06-29 |
| Last Update Date | 2023-03-31 |