NPI | 1245653088 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 401891) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 535933) |
Enumeration Date | 2014-01-30 |
Last Update Date | 2025-08-03 |