| NPI | 1942722723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ME CNP181146) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 2330167) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2020-06-30 |