| NPI | 1508113374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 2018012591) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2280010) |
| Enumeration Date | 2012-08-10 |
| Last Update Date | 2018-12-27 |