| NPI | 1952139677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology (Licence: MA RN2353483) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2353483) |
| Enumeration Date | 2024-07-24 |
| Last Update Date | 2024-10-11 |