NPI | 1730553371 |
---|---|
Former Name | MARY ELIZABETH KERVANDJIAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2371789) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NH 088764-23) |
Enumeration Date | 2015-11-19 |
Last Update Date | 2024-07-24 |