| NPI | 1053355768 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NJ 26NO08114600)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NJ NN81146)  | 
| Enumeration Date | 2006-06-15 | 
| Last Update Date | 2019-10-07 |