| NPI | 1104296524 |
|---|---|
| Former Name | IVETTE AMNERYS MARTINEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NJ 26NJ00591600) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: NJ 26NJ00591600) |
| Enumeration Date | 2015-09-28 |
| Last Update Date | 2024-01-22 |