| NPI | 1023410552 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 26NJ00530100) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: DE LB-0000292) | 
| Enumeration Date | 2014-09-16 | 
| Last Update Date | 2019-07-09 |