| NPI | 1437798089 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00966700) |
| Additional Taxonomies | 364SF0001X Clinical Nurse Specialist, Family Health (Licence: NJ 26NJ00966700) |
| Enumeration Date | 2019-12-30 |
| Last Update Date | 2024-08-09 |