| NPI | 1790193845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA RN2284489) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2284489) |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2021-10-09 |