| NPI | 1609532548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NJ 26NJ01228900) |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care (Licence: NJ 26NJ01228900) |
| Enumeration Date | 2021-11-15 |
| Last Update Date | 2022-01-12 |