| NPI | 1760628259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F334856-1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NJ 27NJ00132800) |
| Enumeration Date | 2009-01-05 |
| Last Update Date | 2009-01-05 |