| NPI | 1598102816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 2021031341) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2258406) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2258406) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 95023897) | |
| Enumeration Date | 2013-05-28 |
| Last Update Date | 2024-01-23 |