| NPI | 1063843340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26NJ00452300) |
| Additional Taxonomies | 286500000X Military Hospital (Licence: NJ 26NR12203000) |
| Enumeration Date | 2013-12-11 |
| Last Update Date | 2018-03-17 |