| NPI | 1922678564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: MA RN26303986) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 2303986) |
| Enumeration Date | 2021-06-27 |
| Last Update Date | 2023-02-27 |