NPI | 1134762743 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403067) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 713642) |
Enumeration Date | 2019-10-26 |
Last Update Date | 2023-06-04 |