| NPI | 1063421808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 9429523) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: NJ 26NN06537700) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2017-10-13 |