| NPI | 1912419169 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NJ 26NJ00774900)  | 
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: NJ 26NJ00774900)  | 
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 26NJ00774900)  | |
| Enumeration Date | 2017-10-27 | 
| Last Update Date | 2024-07-15 |