NPI | 1023405842 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NJ 26NJ00558500) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR17038400) |
Enumeration Date | 2015-04-20 |
Last Update Date | 2015-04-20 |