| NPI | 1962632208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: MA RN2277656) |
| Additional Taxonomies | 171100000X Acupuncturist |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2025-11-07 |