| NPI | 1578588927 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA VP003683B) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NJ00019600) | 
| Enumeration Date | 2006-07-13 | 
| Last Update Date | 2014-12-17 |