NPI | 1164745584 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402390) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 22-605331) |
Enumeration Date | 2010-03-12 |
Last Update Date | 2018-06-28 |