NPI | 1720664329 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NJ 26NJ01137700) |
Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NJ 26) |
363LP2300X Nurse Practitioner, Primary Care (Licence: NJ 26NR11741400) | |
Enumeration Date | 2021-03-23 |
Last Update Date | 2021-04-21 |