NPI | 1679067896 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2294311) |
Additional Taxonomies | 163WP0807X Registered Nurse, Psych/Mental Health, Child & Adolescent (Licence: MA RN2294311) |
Enumeration Date | 2018-06-20 |
Last Update Date | 2022-06-29 |