| 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 |