| NPI | 1083614499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NJ 26NN03874000) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MD R067076) |
| 363LF0000X Nurse Practitioner Family (Licence: NY 331781) | |
| 363LF0000X Nurse Practitioner Family (Licence: VA 0024172126) | |
| 363LF0000X Nurse Practitioner Family (Licence: PA VP001240B) | |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2016-12-24 |