NPI | 1205519485 |
---|---|
Former Name | LILLIAN OCONNOR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 405653) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 526872) |
Enumeration Date | 2023-08-14 |
Last Update Date | 2024-09-17 |