| NPI | 1871154112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1021391) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2299206) |
| 363L00000X Nurse Practitioner (Licence: MA RN2299206) | |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2024-08-22 |