| NPI | 1114779840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NJ 26NJ15130900) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 969889) |
| 163W00000X Registered Nurse (Licence: CA 95295135) | |
| 163WE0003X Registered Nurse, Emergency (Licence: NJ 26NR19308300) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95034229) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F355672-01) | |
| Enumeration Date | 2024-04-04 |
| Last Update Date | 2025-04-23 |