NPI | 1013470350 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402713) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 690234) |
Enumeration Date | 2019-04-12 |
Last Update Date | 2024-03-06 |