| NPI | 1063674034 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5008990) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NN08411600) |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2022-07-21 |