| NPI | 1912882937 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ15381200) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR22417000) |
| 163W00000X Registered Nurse (Licence: NY 836819-01) | |
| Enumeration Date | 2025-08-08 |
| Last Update Date | 2025-08-08 |