| NPI | 1124883228 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NJ 26NJ15062600) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: AZ 3228739) |
| 363LF0000X Nurse Practitioner Family (Licence: TX 1208251) | |
| 363LF0000X Nurse Practitioner Family (Licence: NY F353531) | |
| 363LF0000X Nurse Practitioner Family (Licence: NJ 26NJ15062600) | |
| Enumeration Date | 2024-02-16 |
| Last Update Date | 2025-08-29 |