| NPI | 1407906704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA RN214795) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 214795) |
| 363L00000X Nurse Practitioner (Licence: NH 069512-23) | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2024-10-31 |