NPI | 1609415645 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F347889-01) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR20600600) |
163WP0808X Registered Nurse, Psych/Mental Health (Licence: NY 742389) | |
363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ01259900) | |
Enumeration Date | 2019-12-21 |
Last Update Date | 2022-01-30 |