NPI | 1518108554 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F402173) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 525389) |
Enumeration Date | 2009-03-22 |
Last Update Date | 2021-02-02 |