| NPI | 1205812377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA VP006973C) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN324498L) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: NJ 26NJ00438800) | |
| 163W00000X Registered Nurse (Licence: NJ 26NR08499200) | |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2014-05-26 |