| NPI | 1972150399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP018873) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NJ00833800) |
| Enumeration Date | 2019-08-21 |
| Last Update Date | 2019-08-21 |