| NPI | 1265652101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 303808) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NJ00520700) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2021-09-20 |