| NPI | 1912327123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: RI NPP37711) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology (Licence: MA RN2279104) |
| Enumeration Date | 2014-04-27 |
| Last Update Date | 2014-04-27 |