| NPI | 1972149987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MA RN2338460) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2019-11-25 |
| Last Update Date | 2021-03-01 |