| NPI | 1730718578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NJ 26NJ01024600) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 26NJ01024600) |
| 207Q00000X Family Medicine (Licence: PA SP022025) | |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2020-10-08 |