| NPI | 1710704077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MA RN265490) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 1710704077) |
| Enumeration Date | 2024-09-26 |
| Last Update Date | 2025-03-20 |