| NPI | 1992637763 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 688674) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR23818800) |
| Enumeration Date | 2026-06-03 |
| Last Update Date | 2026-06-03 |