| NPI | 1073409561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: NJ 26NJ15346600) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NJ15346600) |
| Enumeration Date | 2025-06-13 |
| Last Update Date | 2025-10-06 |