| NPI | 1407936164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN9354066) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00086100) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 15345) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-08-19 |