NPI | 1093312068 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NJ 26NJ01064300) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NJ 26NR13351600) |
Enumeration Date | 2020-10-02 |
Last Update Date | 2023-04-14 |