| NPI | 1457506057 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA 284312) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00486600) | 
| Enumeration Date | 2008-11-24 | 
| Last Update Date | 2023-08-24 |