| NPI | 1790267714 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ01441700)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN254953)  | 
| 363LW0102X Nurse Practitioner, Women's Health (Licence: NJ 26NJ01441700)  | |
| Enumeration Date | 2018-09-06 | 
| Last Update Date | 2023-05-02 |