NPI | 1972256642 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ01070300) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F346856-01) |
Enumeration Date | 2022-02-01 |
Last Update Date | 2023-09-11 |