| NPI | 1962507020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP001514C) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NN07978900) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2018-03-16 |