NPI | 1083164404 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ01175900) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR18737400) |
363LF0000X Nurse Practitioner, Family (Licence: NJ F06211160) | |
Enumeration Date | 2016-10-10 |
Last Update Date | 2021-08-14 |