| NPI | 1164574166 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA 258694) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 258694) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2007-08-28 |