| NPI | 1821649153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA AG07190316) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA AG07190316) |
| Enumeration Date | 2019-09-27 |
| Last Update Date | 2020-12-23 |