| NPI | 1104355098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP017222) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NJ00730000) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2018-04-06 |