NPI | 1053887497 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 404988) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 758713) |
Enumeration Date | 2018-10-23 |
Last Update Date | 2023-06-05 |