| NPI | 1609203991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY f338305-1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26nj00438900) |
| Enumeration Date | 2013-10-01 |
| Last Update Date | 2013-10-01 |