| NPI | 1508806159 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NJ 26NN03287900) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA VP003411F) | 
| Enumeration Date | 2006-06-08 | 
| Last Update Date | 2007-07-08 |