| NPI | 1285164111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 007142) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2328282) |
| 363L00000X Nurse Practitioner (Licence: NJ NJDCATEMP-006820) | |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2022-05-12 |