| 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 |