NPI | 1124883228 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NJ 26NJ15062600) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 353531) |
Enumeration Date | 2024-02-16 |
Last Update Date | 2025-02-28 |