| NPI | 1689059636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2273706) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 00000) |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2022-06-20 |