| NPI | 1104469196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA RN2311963) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: MA RN2311963) |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2025-04-07 |