| NPI | 1356994347 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA RN2286457) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2286457) |
| Enumeration Date | 2019-07-19 |
| Last Update Date | 2019-12-03 |