| NPI | 1902156623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2278891) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2278891) |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2016-05-05 |