| NPI | 1740879915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA RN2362810) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5013977) |
| Enumeration Date | 2021-01-13 |
| Last Update Date | 2022-07-27 |