| NPI | 1619265279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5014743) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NJ NR13231200) |
| 164W00000X Licensed Practical Nurse (Licence: NJ NJ00327500) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00327500) | |
| Enumeration Date | 2011-07-18 |
| Last Update Date | 2021-08-06 |