| NPI | 1518383223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MA RN2326129) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5006766) |
| 363LF0000X Nurse Practitioner Family (Licence: NC 5006766) | |
| Enumeration Date | 2014-03-06 |
| Last Update Date | 2019-10-10 |