| NPI | 1124263918 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SX0200X Clinical Nurse Specialist, Oncology (Licence: NJ 26NJ00165800) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 304487) |
| Enumeration Date | 2008-12-08 |
| Last Update Date | 2008-12-08 |