NPI | 1407201189 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NJ 26NJ00633600) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11023962) |
363LF0000X Nurse Practitioner, Family (Licence: NJ 26nj00633600) | |
Enumeration Date | 2016-04-29 |
Last Update Date | 2024-03-25 |