| NPI | 1790592624 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NJ 26NJ15203000) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ15203000) | 
| Enumeration Date | 2024-12-13 | 
| Last Update Date | 2025-01-27 |