NPI | 1982052882 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95011288) |
Additional Taxonomies | 282NC0060X General Acute Care Hospital, Critical Access (Licence: NJ 26NJ00641300) |
Enumeration Date | 2016-06-01 |
Last Update Date | 2019-07-09 |