| NPI | 1124422951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA 2300692) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NJ00719500) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 2300692) | |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2017-06-21 |