NPI | 1023640406 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ01020700) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NJ 26NJ01020700) |
363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP021478) | |
Enumeration Date | 2020-02-04 |
Last Update Date | 2020-10-19 |