| NPI | 1780933994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 337354) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 337354) |
| 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00446600) | |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2019-01-22 |