| NPI | 1619584091 |
|---|---|
| Former Name | MEDITA LEWIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2307676) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2307676) |
| Enumeration Date | 2020-09-29 |
| Last Update Date | 2021-09-02 |