| NPI | 1104547504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NJ 26NJ01365000) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR17307100) |
| Enumeration Date | 2022-09-06 |
| Last Update Date | 2022-12-21 |