| NPI | 1851309108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA 151955) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 151955) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2009-01-28 |