NPI | 1497153308 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402745) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 637111) |
Enumeration Date | 2014-12-09 |
Last Update Date | 2019-07-26 |