| NPI | 1184949612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA RN280870) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN280870) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 280870) | |
| Enumeration Date | 2010-03-27 |
| Last Update Date | 2020-01-07 |