| NPI | 1497711048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 112291) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: MA 112291) |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2007-07-08 |