NPI | 1578153946 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ01076600) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NJ01076600) |
Enumeration Date | 2021-01-20 |
Last Update Date | 2022-03-29 |