| NPI | 1568637411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 25MP00449700) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00449700) |
| 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00449700) | |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2024-02-27 |