| NPI | 1871194381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2347607) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA 254538) |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2023-02-16 |