NPI | 1235791989 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F403091) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR20051400) |
Enumeration Date | 2019-07-02 |
Last Update Date | 2020-08-19 |