| NPI | 1639768500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26NJ01114100) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR15566200) |
| Enumeration Date | 2021-01-14 |
| Last Update Date | 2021-02-23 |