| NPI | 1578126884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM 59643) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NJ00914800) |
| Enumeration Date | 2019-04-22 |
| Last Update Date | 2025-03-03 |