| NPI | 1770091092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN10003148) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NY 836194) |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2024-10-01 |