| NPI | 1669060158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 12200144) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA AG12200144) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MA RN284732) | |
| Enumeration Date | 2021-01-09 |
| Last Update Date | 2024-04-09 |