| NPI | 1467502872 |
|---|---|
| Former Name | ALICE MARIE BROCKWAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA 131614) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NH 032065-23-06) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NY F340734-1) | |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2016-08-05 |