| NPI | 1639783780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA rn2307560) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA rn2307560) |
| Enumeration Date | 2020-09-05 |
| Last Update Date | 2022-11-17 |