| NPI | 1265838932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 26NJ00915300) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00915300) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP016264) | |
| Enumeration Date | 2014-11-07 |
| Last Update Date | 2021-08-06 |