| NPI | 1871078204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA RN225362) |
| Additional Taxonomies | 208800000X Urology (Licence: MA RN225362) |
| Enumeration Date | 2018-10-02 |
| Last Update Date | 2020-10-22 |