| NPI | 1962736710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F335702-1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00226800) |
| Enumeration Date | 2009-09-28 |
| Last Update Date | 2009-09-28 |