| NPI | 1639986805 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MA RN10015833) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: MA RN10015833) |
| Enumeration Date | 2024-12-11 |
| Last Update Date | 2024-12-11 |