| NPI | 1558772392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 195577) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ TAP5579) |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2019-07-17 |