| NPI | 1699380162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: NJ 26NJ15080000) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NJ15080000) |
| 363LF0000X Nurse Practitioner Family (Licence: NY 345667) | |
| Enumeration Date | 2020-09-11 |
| Last Update Date | 2025-05-14 |