| NPI | 1770904021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NJ 26NJ00474100) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NR07126800) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: PA SP015266) | |
| 363LA2200X Nurse Practitioner Adult Health (Licence: MD R223947) | |
| 363LG0600X Nurse Practitioner Gerontology (Licence: NJ 26NJ00474100) | |
| 363LP2300X Nurse Practitioner Primary Care (Licence: PA SP015266) | |
| Enumeration Date | 2014-01-03 |
| Last Update Date | 2018-06-18 |