| NPI | 1790152544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NJ 26NJ00654100) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: PA SP015772) |
| Enumeration Date | 2015-08-27 |
| Last Update Date | 2017-05-10 |