| NPI | 1699744979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA 137910) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA 137910) |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2007-07-08 |