| NPI | 1982158515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 2279920) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2279920) |
| Enumeration Date | 2016-08-11 |
| Last Update Date | 2023-12-21 |