| NPI | 1275183931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL RN9464322) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 13767) |
| 363L00000X Nurse Practitioner (Licence: NJ 26NJ15128000) | |
| 363LF0000X Nurse Practitioner Family (Licence: FL 100) | |
| 363LF0000X Nurse Practitioner Family (Licence: NY F345892-01) | |
| Enumeration Date | 2019-09-16 |
| Last Update Date | 2024-10-10 |