NPI | 1710510201 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ01021400) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA RN671437) |
Enumeration Date | 2020-02-13 |
Last Update Date | 2021-05-18 |