NPI | 1316495542 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F401876) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 549041) |
Enumeration Date | 2016-09-16 |
Last Update Date | 2018-10-02 |