| NPI | 1295513554 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 26NJ14944000) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F311470) | 
| Enumeration Date | 2023-09-18 | 
| Last Update Date | 2024-06-18 |