| NPI | 1043102270 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NJ 26NR24682000) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 717387) |
| Enumeration Date | 2025-07-21 |
| Last Update Date | 2025-07-21 |