| NPI | 1902498868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: NJ 26NJ01089600) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NJ 26NJ01089600) |
| Enumeration Date | 2021-02-10 |
| Last Update Date | 2024-02-21 |