| NPI | 1629616404 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00998400) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NJ00998400) | 
| 207Q00000X Family Medicine (Licence: NJ 26NJ00998400) | |
| Enumeration Date | 2019-12-12 | 
| Last Update Date | 2021-04-26 |