| NPI | 1780878124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: PA SP010141) |
| Additional Taxonomies | 163WR0006X Registered Nurse Registered Nurse First Assistant (Licence: PA RN250407L) |
| 163WR0006X Registered Nurse Registered Nurse First Assistant (Licence: NJ 26NR14086200) | |
| 363LF0000X Nurse Practitioner Family (Licence: NJ 26NJ00197200) | |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2020-06-16 |