| NPI | 1639534621 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: NJ 26NJ00609100)  | 
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: PA SP017746)  | 
| Enumeration Date | 2015-12-18 | 
| Last Update Date | 2022-06-01 |