NPI | 1073380788 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 406455) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 693464) |
Enumeration Date | 2023-12-04 |
Last Update Date | 2024-10-21 |