| NPI | 1134564735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY F306560) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NJ 26NJ00431400) |
| Enumeration Date | 2013-05-08 |
| Last Update Date | 2017-12-27 |