| NPI | 1295243715 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP018248)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00797800)  | 
| Enumeration Date | 2018-01-18 | 
| Last Update Date | 2022-02-04 |