| NPI | 1669001368 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NJ 26NJ01032200) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR13290500) |
| Enumeration Date | 2020-04-04 |
| Last Update Date | 2025-01-20 |