| NPI | 1598122863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA RN251761) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MO 2015019131) |
| Enumeration Date | 2016-01-18 |
| Last Update Date | 2022-05-12 |