| NPI | 1841611894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA AG0714151) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA AG0714151) |
| 163W00000X Registered Nurse (Licence: MA RN2285147) | |
| Enumeration Date | 2013-12-18 |
| Last Update Date | 2015-09-24 |