| NPI | 1457911059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: NY F310834-01) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: NJ 26NJ01337000) |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2022-08-24 |