| NPI | 1043783608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA RN2328557) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2328557) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MA RN2328557) | |
| Enumeration Date | 2019-01-07 |
| Last Update Date | 2022-08-29 |