| NPI | 1861045478 |
|---|---|
| Former Name | KRISTEN REGO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA RN2280155) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2280115) |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2019-10-23 |