NPI | 1053089359 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA sp029004) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA Rn720105) |
207Q00000X Family Medicine (Licence: NJ 26nj15125700) | |
Enumeration Date | 2021-09-01 |
Last Update Date | 2025-03-19 |