| NPI | 1073858544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2258602) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 2258602) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MA RN2258602) | |
| Enumeration Date | 2012-12-10 |
| Last Update Date | 2024-08-21 |