| NPI | 1053932202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11033658) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ NJDCATEMP-015735) |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2024-06-28 |