| NPI | 1215229596 |
|---|---|
| Former Name | KELLY NUSSBAUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0809X Clinical Nurse Specialist Psychiatric/Mental Health, Adult (Licence: NJ 26NC07471600) |
| Enumeration Date | 2011-05-05 |
| Last Update Date | 2011-05-05 |