| NPI | 1912416645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00436500) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA UP006642B) |
| Enumeration Date | 2017-09-26 |
| Last Update Date | 2017-09-26 |