NPI | 1508582040 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP026331) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ01345500) |
Enumeration Date | 2022-10-17 |
Last Update Date | 2024-11-21 |