| NPI | 1578547980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA 196457) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 600047) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2020-10-27 |