NPI | 1104296524 |
---|---|
Former Name | IVETTE AMNERYS MARTINEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/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 |