| NPI | 1720597701 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 26NJ00764200)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024180984)  | 
| Enumeration Date | 2017-09-22 | 
| Last Update Date | 2025-07-10 |