| NPI | 1790443364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA RN2258797) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2258797) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MA RN2258797) | |
| Enumeration Date | 2021-12-01 |
| Last Update Date | 2021-12-09 |