| NPI | 1508142209 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NH 049695-23)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00346000)  | 
| Enumeration Date | 2011-10-25 | 
| Last Update Date | 2015-06-02 |