| NPI | 1407279631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5008874) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 26NJ00473200) |
| Enumeration Date | 2014-01-23 |
| Last Update Date | 2022-08-19 |