| NPI | 1972364768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F352754-01) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ14966500) |
| Enumeration Date | 2024-01-18 |
| Last Update Date | 2025-04-14 |