| NPI | 1790013910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 280880) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 280880) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MA 280880) | |
| Enumeration Date | 2009-11-28 |
| Last Update Date | 2020-01-09 |