| NPI | 1982617262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN-TEMP3354) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 2431P) |
| 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: MA RN-TEMP3354) | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2020-11-04 |