| NPI | 1194240390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26NJ01125900) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 308383) |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2022-05-12 |