NPI | 1194148601 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403177) |
Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: NY 571990) |
363L00000X Nurse Practitioner (Licence: NY 341194) | |
Enumeration Date | 2014-02-04 |
Last Update Date | 2021-02-01 |