NPI | 1538581756 |
---|---|
Former Name | COLLEEN ELIZABETH AVERY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LW0102X Nurse Practitioner Women's Health (Licence: NJ 26NJ01142800) |
Enumeration Date | 2014-01-07 |
Last Update Date | 2022-10-04 |