| NPI | 1972803955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA Applied) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NR09306000) |
| 363L00000X Nurse Practitioner (Licence: NJ 26NJ00332400) | |
| Enumeration Date | 2010-10-25 |
| Last Update Date | 2020-04-09 |