NPI | 1619452513 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NJ 26NJ00876400) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 343638) |
Enumeration Date | 2018-09-27 |
Last Update Date | 2020-08-10 |