NPI | 1457897076 |
---|---|
Former Name | SAMANTIA N BLACK-WRIGHT (BLACK) |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00698000) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26nj00698000) |
Enumeration Date | 2017-01-07 |
Last Update Date | 2024-02-11 |