| NPI | 1639414220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00641900) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP012560) |
| Enumeration Date | 2012-12-07 |
| Last Update Date | 2017-03-07 |