| NPI | 1972068591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2263434) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: MA RN2263434) |
| Enumeration Date | 2019-02-07 |
| Last Update Date | 2024-05-14 |