| NPI | 1568244374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F351407-01) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NR24658200) |
| Enumeration Date | 2023-10-17 |
| Last Update Date | 2024-07-08 |