| NPI | 1639784432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NJ 26NJ01225800) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NV 833005) |
| 363LF0000X Nurse Practitioner Family (Licence: VA 0024180050) | |
| Enumeration Date | 2020-09-09 |
| Last Update Date | 2022-03-12 |