NPI | 1275813404 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 401413) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 573440) |
Enumeration Date | 2011-08-19 |
Last Update Date | 2017-06-21 |