| NPI | 1396371761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 2328776) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 2328776) |
| Enumeration Date | 2020-03-18 |
| Last Update Date | 2021-08-12 |