| NPI | 1700077989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NJ 26NN06756800) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: PA tpn003564N) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2007-08-05 |