| NPI | 1043860174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ01003100) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP020814) |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2020-10-19 |