NPI | 1417365776 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NJ 26NJ15053300) |
Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP013879) |
363LP2300X Nurse Practitioner, Primary Care (Licence: PA SP013879) | |
Enumeration Date | 2014-07-30 |
Last Update Date | 2025-01-13 |