NPI | 1275179145 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403556) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 778683-01) |
Enumeration Date | 2019-11-26 |
Last Update Date | 2021-07-01 |