| NPI | 1558481002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 26NN10017100) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F302595-1) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2007-07-08 |