| NPI | 1912240144 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NJ 26NJ00425400) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 305707) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 26NJ00425400) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NY 340807) | |
| Enumeration Date | 2013-04-06 |
| Last Update Date | 2021-05-26 |