| NPI | 1972855401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ01016700) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 338734) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 16999) | |
| Enumeration Date | 2012-10-08 |
| Last Update Date | 2021-04-12 |