| NPI | 1417612003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NJ 26nr19526100) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NJ01278100) |
| Enumeration Date | 2021-11-08 |
| Last Update Date | 2022-03-25 |