| NPI | 1629580154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: MA RN2320171) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 2320171) |
| 363L00000X Nurse Practitioner (Licence: MA 2320171) | |
| Enumeration Date | 2017-10-24 |
| Last Update Date | 2023-11-10 |