| NPI | 1558200477 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: NJ 26NJ15626300) |
| Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: NJ 26NR24150500) |
| Enumeration Date | 2026-03-26 |
| Last Update Date | 2026-08-10 |