NPI | 1255671079 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402485) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 659552) |
Enumeration Date | 2013-02-15 |
Last Update Date | 2023-08-07 |