NPI | 1114329562 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: MA RN2276800) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA rn2276800) |
363LG0600X Nurse Practitioner, Gerontology (Licence: CT 6127) | |
Enumeration Date | 2014-09-17 |
Last Update Date | 2022-03-21 |