NPI | 1811375736 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP014589) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NJ 26NJ15159300) |
Enumeration Date | 2015-05-12 |
Last Update Date | 2025-05-05 |