| NPI | 1770139891 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NJ 26NJ00945800) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00945800) | 
| Enumeration Date | 2019-08-14 | 
| Last Update Date | 2019-08-22 |