| NPI | 1679851711 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2298448)  | 
| Additional Taxonomies | 133V00000X Dietitian, Registered | 
| 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00675800)  | |
| Enumeration Date | 2011-07-22 | 
| Last Update Date | 2024-09-12 |