| NPI | 1790468668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NJ 26NJ14895100) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NJ14895100) |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2024-05-03 |