| NPI | 1982202073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA RN2284629) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: MA 2284629) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN2284629) | |
| Enumeration Date | 2020-10-12 |
| Last Update Date | 2023-01-31 |