NPI | 1528505740 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 258924) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 258924) |
Enumeration Date | 2017-01-25 |
Last Update Date | 2024-01-08 |