| NPI | 1104297605 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00597800) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 307222) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 341708) | |
| Enumeration Date | 2015-10-09 |
| Last Update Date | 2023-02-16 |