| NPI | 1174087142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NJ 26NJ00889400) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 26NR20504700) |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2020-11-24 |