NPI | 1407393093 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11005424) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: DE LG-0001109) |
363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00699500) | |
Enumeration Date | 2017-01-20 |
Last Update Date | 2022-11-23 |