NPI | 1164012399 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26NJ01104200) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ01104200) |
Enumeration Date | 2021-01-21 |
Last Update Date | 2025-01-15 |