| NPI | 1629508064 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00707300)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR13801600)  | 
| Enumeration Date | 2017-06-18 | 
| Last Update Date | 2017-08-03 |