| NPI | 1164707642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00347400) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NJ 26NR09491600) |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2019-06-20 |