NPI | 1912667429 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 9068) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ01230300) |
Enumeration Date | 2021-12-23 |
Last Update Date | 2022-03-16 |