| NPI | 1255529707 |
|---|---|
| Former Name | CATHERINE CUSTODIO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 26NJ00683400) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F304695) |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2017-02-20 |