| NPI | 1639414436 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NJ 26NJ00405900) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 26NJ00405900) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F308702-1) | |
| Enumeration Date | 2012-12-05 |
| Last Update Date | 2021-02-11 |