| NPI | 1508330614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN277739) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA RN277739) |
| 163W00000X Registered Nurse (Licence: MA RN277739) | |
| Enumeration Date | 2019-01-11 |
| Last Update Date | 2019-05-06 |