NPI | 1407372238 |
---|---|
Former Name | KRSITEN E FANTEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00982300) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CT 7169) |
Enumeration Date | 2017-08-14 |
Last Update Date | 2020-03-13 |