| 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 |