| NPI | 1962130302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 4053788) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2302151) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: MA RN2302151) | |
| Enumeration Date | 2022-08-12 |
| Last Update Date | 2026-06-01 |