| NPI | 1962168963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NJ 26NJ01234100) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NV 845930) |
| Enumeration Date | 2021-11-13 |
| Last Update Date | 2022-02-02 |