| NPI | 1710224373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: PA SP012374) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: NJ 26NJ01119000) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2021-10-04 |