| NPI | 1336282490 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP012026) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ NJ00118900) | 
| Enumeration Date | 2007-02-15 | 
| Last Update Date | 2014-01-07 |