| NPI | 1851898068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MA RN277188) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: GA RN259172) |
| 251S00000X Community/Behavioral Health (Licence: GA RN259172) | |
| 363LA2200X Nurse Practitioner Adult Health (Licence: GA RN259172) | |
| Enumeration Date | 2018-04-12 |
| Last Update Date | 2021-07-09 |