| NPI | 1063655066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NJ 26NJ00230100) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: NY 305032) |
| Enumeration Date | 2009-04-07 |
| Last Update Date | 2023-11-30 |