| NPI | 1790260180 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NJ 26NJ00807500) | 
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NJ 26NJ00807500) | 
| Enumeration Date | 2018-10-01 | 
| Last Update Date | 2023-03-07 |