NPI | 1154361897 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: NJ 1524644) |
Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health (Licence: NJ 26NO06557200) |
Enumeration Date | 2006-06-08 |
Last Update Date | 2019-01-30 |