| NPI | 1134538879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 259466) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA 259466) |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2014-08-06 |