NPI | 1083007595 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F403205-01) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 22696034) |
Enumeration Date | 2015-03-07 |
Last Update Date | 2020-09-27 |