NPI | 1508109315 |
---|---|
Former Name | ELIZABETH OSTROM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 40 401579) |
Enumeration Date | 2013-03-29 |
Last Update Date | 2019-08-06 |