NPI | 1730531088 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NJ 26NJ15360200) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 706473-1) |
363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382735-1) | |
Enumeration Date | 2016-07-11 |
Last Update Date | 2025-10-03 |