| NPI | 1639567530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CT 5942) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA RN212098) |
| Enumeration Date | 2014-12-30 |
| Last Update Date | 2020-01-16 |