| NPI | 1356829121 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA RN2295826)  | 
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA RN2295826)  | 
| Enumeration Date | 2018-08-02 | 
| Last Update Date | 2018-11-26 |