| NPI | 1093389637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP023022) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NJ01147500) |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2022-01-17 |