| NPI | 1962148031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA RN276775) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MA AG07220107) |
| Enumeration Date | 2022-05-10 |
| Last Update Date | 2023-03-15 |